准分子激光原位角膜磨镶术前后泪液中神经生长因子水平及泪膜稳定.docVIP

准分子激光原位角膜磨镶术前后泪液中神经生长因子水平及泪膜稳定 　【摘要】 目的 探讨内源性神经生长因子（nerve growth factor，NGF）在准分子激光原位角膜磨镶术（laser in situ keratomileusis，LASIK）后干眼中的作用机制。方法 LASIK术前及术后1天、2天、10天及30天在17例患者（34眼）下睑结膜囊内抽取泪液标本，采用双抗体夹心酶联免疫吸附分析法检测泪液中NGF含量，同时行泪膜稳定性的检查，并对两者行相关性分析。结果 NGF含量在术前平均值为（21.96±8.22）μg/ml，术后1天、2天、10天含量分别为(12.76±3.55)μg/ml、(11.01±4.66)μg/ml、(13.55±4.93)μg/ml，与术前比较差异有统计学意义（Plt;0.05）；术后30天含量(19.16±8.79)μg/ml，与术前比较差异无统计学意义(Pgt;0.05)。术前泪膜破裂时间（breaking-up time，BUT）均值为(12.62±1.99)s，术后1天、2天、10天和30天分别为(4.68±1.77)s、(4.84±1.92)s、(7.36±1.53)s和(8.82±3.08)s，与术前比较差异有统计学意义(Plt;0.05)；术后1天与2天比较差异无统计学意义(Pgt;0.05)，术后1天（2天）、10天、30天比较差异均有统计学意义(Plt;0.05）。泪液中NGF含量与泪膜稳定性具有正相关（r=0.484，Plt;0.01）。结论 LASIK术后泪液NGF的含量存在一个由降低到正常的动态变化过程，NGF含量变化是泪膜稳定性下降的相关因素之一。 【关键词】 准分子激光角膜切削术；神经生长因子；泪膜稳定性；干眼 Relationship between the levels of nerve growth factor in tears and tear film stability after LASIK ［Abstract］ Objective To study the mechanism of endogenous nerve growth factor(NGF) in the dry eye after LASIK.Methods Nerve growth factor levels in the tears of 34 eyes before and after LASIK were studied with a monoclonal antibody based ELISA before LASIK and 1 day，2 days，10 days，and 30 days after LASIK.Tear film stability was examined during the same visits.And then the relationship between the levels of NGF in tears and tear film stability in the eyes of pre and postoperative LASIK patients was studied.Results Mean value of NGF before LASIK was (21.96±8.22)μg/ml and mean values at 1 day，2 days，10 days and 30 days after LASIK were(12.76±3.55)μg/ml，(11.01±4.66)μg/ml，(13.55±4.93)μg/ml，(19.16±8.79)μg/ml，respectively.The NGF levels in tears at the first three visits post-operation were significantly different from levels in the pre-operative group.(Plt;0.05).However，There was no significant difference between the pre-surgical level and the level at the 30 days visit post-operation(Pgt;0.05).Tear film stability before LASIK was(12.62±1.99)seconds，and at 1 day，2 days，10 days and 30days after LASIK，it was(4.68±1.77) seconds，(4.84±1.92)